Mayo Clinic Q and A: Defining head and neck cancer
DEAR MAYO CLINIC: A co-worker recently was diagnosed with oral cancer after a nagging cough led him to the doctor. It got me wondering about the incidence of head and neck cancer and what I should be screened for. I'm in my mid-40s and try to be mindful of getting an annual physical.
ANSWER: There are many types of head and neck cancers, which is a broad category used to describe any cancer that starts in the head or neck, including the mouth, nose and throat.
Head and neck cancers account for nearly 4% of all cancers in the U.S., according to the National Cancer Institute. These cancers are more than twice as common among men as women and are diagnosed more often among people over 50.
Alcohol and tobacco use, including chewing tobacco, are among the top causes of head and neck cancer, especially cancer of the mouth, pharynx and voice box. However, there has been an increase in throat cancer in recent years in people who do not smoke or drink.
Data from the American Cancer Society indicates the cause is due to HPV, a sexually transmitted infection that is thought to affect almost 80% of all adults at some point in their lives.
Types of head and neck cancers
The most common head and neck cancers include:
Tonsil cancer Tonsil cancer is an abnormal growth of cells that forms in a tonsil. Your tonsils are two oval-shaped pads in the back of your mouth that are part of your body's germ-fighting immune system. Tonsil cancer often is diagnosed late in the disease, when cancer has spread to nearby areas, such as the lymph nodes in the neck.
While it's not clear what causes tonsil cancer, health care professionals are finding that HPV is detected in most tonsil cancers in the U.S.
Soft palate cancer Soft palate cancer begins in the cells of the soft palate, which is located on the upper portion of the back of your mouth, behind your teeth. Soft palate cancer is considered a type of throat cancer. Soft palate cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Risk factors include using tobacco, drinking alcohol, infection with HPV and taking medication that suppresses your immune system.
Tongue cancer Several types of cancer can affect the tongue, but tongue cancer most often begins in the thin, flat squamous cells that line the surface of the tongue. The type of cells involved in your tongue cancer helps determine your prognosis and treatment. As with tonsil cancer, increasingly, cancers at the base of the tongue are associated with HPV.
Treatment for head and neck cancers can vary depending on the size, location and type of cancer. Surgery is common, and there are now minimally invasive operations, such as transoral robotic surgery and transoral laser microsurgery. Patients also may receive chemotherapy, immunotherapy or targeted drug therapy as well as radiation.
If reconstructive surgery is required, patients may experience changes in their ability to talk or eat. Rehabilitative services often are available to help patients in their recovery.
Reducing your risk
There are several things you can do to reduce your risk of developing head and neck cancer, including:
Quit smoking. Smoking is the leading cause of head and neck cancer. If you smoke, quit as soon as possible. Marijuana users may be at higher risk for head and neck cancer, as well.
Limit alcohol consumption. Heavy alcohol consumption also is a risk factor for head and neck cancer. If you drink alcohol, do so in moderation.
Protect yourself from HPV. To reduce your risk, get vaccinated against HPV and practice safe sex.
Protect your skin. Exposure to sunlight can increase your risk of skin cancer, but many people forget about taking precautions to cover their face and lips. Wear a hat and sunglasses, and use sunscreen on your face regularly. Also, look for lip protection that includes SPF.
Eat a healthy diet. While a diet rich in fruits, vegetables and whole grains can help reduce your risk of cardiovascular disease, it also can help lower your chances of developing head and neck cancer.
Practice good oral hygiene. Poor oral hygiene can be associated with oral cancer. Brush and floss regularly, and see a dentist for routine checkups. If you find a lump, bump or cut inside the mouth that won't heal, make sure you mention it to your dentist.
Be aware of workplace hazards. If you work in an environment where you are exposed to certain chemicals or dusts, take steps to protect yourself. Wear protective gear and follow safety guidelines to reduce inhalation and irritation of the nose and throat.
Avoid unnecessary radiation exposure. Take precautions to avoid exposure to radiation, which is associated with head and neck cancer.
Your primary health care team can help you determine what screenings might be needed, especially if you are experiencing symptoms that could indicate a head and neck cancer. You also can visit a specialist, known as an otolaryngologist. —Dr. Samip Patel, Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida